I am a 30 year old male, BMI of about 37, but otherwise healthy. My question has multiple parts, and I appreciate any help. On July 23, I began running a fever (101.8), for which I took tylenol. I was seen by a doctor, who treated me for food poisoning. The next day, my fever was 103, and I was again seen and treated (by antibiotic) for a sinus infection. At this point, I began taking a full dose of extra strength tylenol every 3 hours (not a good idea, I know). That Saturday, my fever was up to 105, accompanied by frequent vomiting, dizziness, vertigo, and an inability to sleep or keep food/fluids down. I was admitted to the ER. A CAT Scan was taken and showed my spleen to be 18 cm. All bloodwork and CAT Scans looked normal, and no other issues were found. I was sent home with instructions to take Tylenol for fever and check with my primary care doctor Monday. My PCP checked me for Hepatitis, Pancreatitis, Mono, and a number of other items through bloodwork. I was still running a fever in the 102-103 range and was vomiting. I was treated for my individual symptoms and sent home. My bloodwork came back fine, with the exception of my liver enzymes (high), white blood cell count (and my doctor decided to treat it as non-typable hepatitis. I began having pain in my upper-left ribcage and mentioned this to my PCP.
My bloodwork returned with low white blood cell count (clustered), low platelet count, and high SGOT (about 250) and SGPT (about 260). By Friday (8 days since this had started), my fever was gone and I stopped taking tylenol. In the two weeks since, my white blood cell count and platelets have returned to normal, and my SGOT is ~80 and my SGPT is ~191, but both numbers have gone down each time they have been tested.
I am still having upper-left abdominal pain, and I am worried my spleen is to blame. My PCP wants to wait a few more weeks before having another CAT Scan done, but I am uneasy regarding my spleen's size. I have two questions:
1) Is a spleen of 18 cm a cause for immediate concern, and could this be a temporary enlargement caused by whatever caused me to be so sick?
2) Could the pain I am feeling in my upper-left abdomen be indicative of a serious problem with me spleen? it is not persistent, but feels sharp, and is often accompanied by belching. It does not seem to be brought on by any activity, and occasionally radiates to my lower gut or around my ribcage and to my back. I am not sure if this could be a GI issue or a possible musical-skeletal rib issue.
Thank you for any help.